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Dissertations and Theses Dissertations and Theses

1983

The correlation between expressive language delay in children andtheir motor abilitiesGail G. CunninghamPortland State University

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Recommended CitationCunningham, Gail G., "The correlation between expressive language delay in children and their motor abilities" (1983). Dissertationsand Theses. Paper 3241.

10.15760/etd.3233

AN ABSTRACT OF THE THESIS OF Gail G. Cunningham for the

Master of Science in Speech Communication with an emphasis

in Speech-Language Pathology, presented May 11, 1983.

Title: The Correlation Between Expressive Language Delay in

Children and Their Motor Abilities.

APPROVED BY MEMBERS OF THE THESIS COMMITTEE:

RobertL:caSteel

Lenneberg (1967) noted that as a child matures a gener-

al growth pattern is observed with both language skills and

motor skills co-developing. Most of the research relating to

motor skills deals with articulation skills, oral diadokokin-

etic rates, learning disabilities, and intelligence.

/

Relatively few studies, however, appear to correlate motor

skills with expressive language delay in children.

2

The purpose of the present study was to determine the

correlation between expressive language delay in children and

their gross and fine motor skills. Twenty children five

years through six years, eleven months with a diagnosed ex­

pressive language delay, were selected to participate in the

study. Each was screened on the basis of normal hearing, re­

ceptive vocabulary skills, motor functioning, and an expres­

sive language delay of one year or more. After screening

procedures, each child was administered the Preschool Lan­

guage Scale-PLS (Zimmerman, et al., 1969) and the short form

of the Bruininks-Oseretsky Test of Motor Prof iciency-BOMP

(Bruininks, 1978). The data were analyzed using a Pearson

Product-Moment Correlation along with ~eans, standard devia­

tions, and a one-tailed !-test of significance.

According to the data results, the Standard Score, an

overall measurement of the children's motor skills, indicated

a moderate inverse correlation, r. = -.41, while the Total

Point Score, r. = -.17, and the Percentile Rank, r. = -.28,

had weak inverse correlations. In relation to the individual

test items, negligible correlations were indicated in the

gross motor items, with the exception of "Walking Heel-to­

Toe" and "Catching a Tossed Ball," which obtained positive

correlations, r. = +.13 and +.30, respectively.

There were three out of six fine motor tasks with

low to moderate inverse correlations: "Copying a Circle"

generated a moderately-strong inverse correlation, r. = -.48;

"Copying Overlapping Pencils" and "Response Speed," posted

3

low inverse correlations, r. = -.37, and r. -.24, respective!~

A one-tailed t-test revealed subjects performed these three

items more poorly than the gross motor and some fine motor

tasks on the BOMP. The expressive language delayed children

tended to have deficits in manual dexterity tasks but not in

gross motor tasks.

The results obtained from the present study were com­

patible with the research conducted by Sprague (1961) and

Wolff and Wolff (1972) . Both investigators found significant

correlations between fine motor tasks and expressive language.

Negligible correlations were indicated between gross motor

skills and expressive language. It was concluded by the pre­

sent investigator that children with expressive language de­

lay might have deficient fine motor development.

THE CORRELATION BETWEEN EXPRESSIVE LANGUAGE DELAY

IN CHILDREN AND THEIR MOTOR ABILITIES

by

GAIL G. CUNNINGHAM

A thesis submitted in partial fulfillment of the

requirements for the degree of

MASTER OF SCIENCE IN SPEECH COMMUNICATION: with an emphasis in

SPEECH-LANGUAGE PATHOLOGY

Portland State University 1983

TO THE OFFICE OF GRADUATE STUDIES AND RESEARCH

The members of the Conunittee approve the thesis of

Gail G. Cunningham presented May 11, 1983.

Robert~ asteel ""'

APPROVED:

Theodore G. Grove, Chair, Department of Speech Conununication

Stanley Rauch, Dean, Graduate Studies and Research

ACKNOWLEDGEMENTS

As I reflect back on the task of producing this thesis,

there were endless amounts of hours spent researching, writ­

ing, revising, more revising, typing, and running the study.

The following people deserve special recognition for their

direct and indirect assistance.

I am very grateful to the members of my conunittee, es­

pecially Dr. E. It has been an honor and pleasure to have

had you as my graduate advisor and thesis director. I appre­

ciate your encouragement, direction, and personal concern

during these past two years. Dr. Casteel, thank you for your

contributions and criticism during the initial phases of the

thesis. Your input as a member of my conunittee was of much

value. I also wish to thank Ted Grove for his efforts in

explaining the statistical interpretation of the data.

Thank you everyone!

A special note of recognition goes to my closest, dear­

est friend and roonunate, Marie Cunningham, who was by my side

through the best and worst of times. I am especially thank­

ful for her endless amount of patience, support, encourage­

ment, and words of wisdom. Marie was always ready and will­

ing to listen to my problems and frustrations. I give many,

many thanks for "Mer" being such a special friend to me.

I also need to thank my family for providing me with

iv

the opportunity to pursue my goals and enrich my life through

education. Thank you for allowing me to share my experiences

with you and for never losing faith in me during graduate

school. All of the long distance calls, letters, hugs, and

vacations to Albuquerque helped keep me sane! Mom and Dad,

your youngest daughter finally made it!

Finally, I acknowledge my Lord for providing me with

strength and wisdom during my education. As Isaiah 40:31

says, "But those who hope in the Lord will renew their

strength. They will soar on wings like eagles; they will

run and not grow weary, they will walk and not be faint."

TABLE OF CONTENTS

Page

ACKNOWLEDGEMENTS . . . . . . . iii

LIST OF TABLES . . . . . . . . . . . . . . . . . . vi

CHAPTER

I INTRODUCTION AND STATEMENT OF PURPOSE 1

Introduction . • • . • . • . . . . • . • 1 Statement of Purpose • . . . . • • . . . 2 Operational Definitions . . . • • • 3

II REVIEW OF THE LITERATURE

Historical Background Related Studies • . • Summary . . . . . . . . . . .

III METHODS AND PROCEDURES . . . . . . .

IV

v

REFERENCES

APPENDICES

Methods Procedures

. . . . . . . . . . . . . . . . . . . RESULTS AND DISCUSSION

Results Discussion

. . . . . . . . . . . . . . SUMMARY AND IMPLICATIONS . . . . . . . . . .

Summary . • • • • . • • • • Implications • • • . • • . •

. . . . . . . . . . . . . . . . . .

4

5 8

12

13

13 16

20

20 24

30

30 32

34

37

TABLE

I

II

III

LIST OF TABLES

Mean and Standard Deviation of the Sample's Chronological Age in Comparison to the Expressive Language Age Delay, Mean and Standard Deviation as Measured by the PLS

Mean, Standard Deviation, Analysis of Correlation between the PLS and the BOMP, and t-test results ••.••..••.

Point Score Ranges, Means, Standard Devi­ations, Correlation Coefficients, and t-test Results of the BOMP •.•..•

Page

. . 21

22

23

CHAPTER I

INTRODUCTION AND STATEMENT OF PURPOSE

Introduction

The theory of motor skills relating to linguistic abil­

ities is not new. In 1880, Schultze hypothesized that chil­

dren learn only one behavior at a time. While walking, the

infant learns to push aside language development until the

locomotor action is perfected (McCarthy, 1946). One of the

more recently accepted theories among educators and research­

ers was postulated by Lenneberg (1967) • According to his

biological approach, as a child matures and develops there

is a general growth pattern with both language skills and

motor skills co-developing in early childhood.

Some researchers, such a Kephart, have a different ap­

proach in relation to language skills and motor skills. Ac­

cording to Kephart's theory (1960), higher forms of behavior,

such as reading, writing, and speech, " ••• develop out of

and have roots in motor learning • • " These higher forms

of behavior are dependent upon lower forms of behavior. A

child's development may be blocked at particular stages and

influence the child's performance and development at later

stages. Breakdown occurs in the child's verbal development

as well.

2

Wolff and Wolff {1972) studied the relationship between

motor activity and verbal activity in nursery school and kin-

dergarten age children. Based on the ratings of their teach-

ers, it was concluded that verbal output, or " •• the degree

to which the child emits verbal material • • " is more high-

ly related to gross motor activity. Verbal skills, or " •••

the level of sophistication of the child's speech •.• " were

significantly correlated with fine motor abilities and manual

dexterity. This investigator interpreted these findings as

positive correlations.

Most of the research relating to motor skills deals

with learning disabilities, intelligence, and articulation

skills. There appears to be relatively few studies, however,

correlating motor skills and expressive language delay in

children. It is important to determine whether or not a sig-

nificant relationship exists.

Statement of Purpose

The purpose of this study was to determine the associa-

tion between expressive language delay in children and their

motor abilities. Two questions were addressed in this inves-

tigation:

1. Is there a significant relationship between an in­creased expressive language delay and reduced motor abilities in children with a language delay?

2. What specific gross and fine motor skills had the strongest association with language delay?

Operational Definitions

The following are descriptions of specific terms used

in the investigation.

Expressive Language Delay: This term will refer to language which follows an orderly pattern of language develop­ment, but is not appropriate according to the chrono­logical age (Bangs, 1968). For the purpose of this study, an "expressive language delay" will be where a child is at least one year delayed or more in expres­sive language abilities, as determined by the expres­sive portion of the Preschool Language Scale (Zimmer­man, Steiner, and Evatt, 1969).

3

Gross Motor Skills: This term, as used in the study, will refer to the ability to contract large muscles and move the entire body. Gross motor skills will be assessed with the short form of the Bruininks-Oseretsky Test of Motor Proficiency-BOMP (Bruininks, 1978), using four subtests, including: Running Speech and Agility; Balance; Bilateral Coordination; and Strength.

Fine Motor Skills: This term refers to precise movements performed by small muscles, especially those of the hands, fingers, and forearms. Fine motor skills also involve eye-hand coordination and manipulation of tools arrlsmall objects (Sage, 1977). Each subject's fine motor skills will be assessed with four subtests of the BOMP, including: Response Speed; Visual-Motor Control; Upper-Limb Speed; and Manual Dexterity.

CHAPTER II

REVIEW OF THE LITERATURE

As humans, we have a natural propensity for communica­

tion, which includes both receptive (comprehension), and ex­

pressive (production) modes (Hopper and Naremore, 1978). Ex­

pressive language is described as the verbal interaction be­

tween individuals. The receptive mode involves mental pro­

cesses, which integrates and associates the meaning of the

message.

Language has a tremendous effect on a child's relation­

ship between himself and his environment (Menyuk, 1971).

Through language acquisition new behaviors are developed, in­

cluding organized play and coordinated motor movements (Luria,

1961). Gradually, the child learns how to effectively use

reasoning, mental planning, thought, memory, and imagery to

influence his immediate environment. By the time a child

reaches four years of age, he has acquired a system of verbal

instructions to regulate his own behavior (Luria and Yudovich,

1959). Appropriate language development frees the child from

dependence on immediate events in the environment and allows

the child to act independently within the environment.

Luria (1961) noted that as a child's language develops,

motor skills also are acquired. Historically speaking, re­

searchers (Orton, 1937; Kephart, 1960; Barsch, 1966;

Myklebust, 1971; and Delacato, 1973) have explored the rela­

tionship between language and motor skills. The following

section briefly describes their hypotheses on this subject.

Historical Background

5

There is an hypothesized interrelationship between lan­

guage and motor skills, which has been studied for several

years with mixed results. Theories supporting this interre­

lationship are varied as well. Kephart {1960) and Barsch

(1966) assumed higher forms of behavior (speech, reading, and

writing) have roots in motor learning. On the other hand,

researchers, including Orton {1937), Myklebust (1971), and

Delacato (1973) focused on neurological factors influencing

motor and language learning. Studies, thus far, have correl­

ated motor skills with articulation skills, oral diadokokine­

tic rates, learning disabilities, mental retardation, intel­

ligence, and academic studies. Investigations relating ex­

pressive language and motor behavior, however, are not appar­

ent in the literature.

Theoretical Perspective

Motor theorists, Kephart (1960) and Barsch (1966), con­

ducted extensive research describing motor factors which have

an impact on learning. According to Kephart (1960), higher

forms of behavior develop out of motor learning. Furthermore,

Kephart {1960) states that children with learning disabilities

have an unstable perceptual-motor world and are disorganized

6

motorically, perceptually, and cognitively. A breakdown in

motor acquisition will affect the child's performance in high­

er learning processes as well.

Barsch (1966) theorized motor efficiency to be an im­

portant variable in the development of language efficiency.

Omission of certain motor experiences during infancy may re­

sult later in motor or learning difficulties.

In addition to the motor approach, other theorists in­

cluding Orton (1937), Myklebust (1971), and Delacato (1973),

hypothesized neurological factors affecting motor and lan­

guage deficiencies. According to Orton (1937), many children

with mixed sidedness in motor skills could have comparable

"integrading" (interpreted as mixed dominance in this inves­

tigation) between critical areas of the brain for various lan­

guage abilities.

Myklebust (1971), also focusing on neurological aspects

affecting motor and language skills, stated that children with

language deficits are "clumsy." Their deficit is represented

by a generalized neurological dysfunction. Although, a clear­

ly defined type of deficit in the motor and sensory spheres

does not exist.

Delacato (1973) theorized language and motor develop­

ment to be a maturational process. Difficulties in these

areas may be due to incomplete neurological organization.

The failure to pass through sequences of development indicates

poor neurological development and may result in problems of

mobility and conununication (Delacato, 1973).

7

Shirley (1933), Gessel! (1954), and Lenneberg (1967)

discussed the relationship between motor and language devel­

opment from a biological approach. Although earlier than

other researchers mentioned, Shirley hypothesized that lin­

guistic development is held in "abeyance" at the time when

motor progress is rapid. Gessellstated that motor and lan­

guage development does not proceed at the same pace, but, in­

stead, while one system develops vigorously, the other may be

held dormant, and vice versa. According to Lenneberg's model,

there is a "synchronization" of language and motor milestones.

Lenneberg stressed that language onset is not a consequence

of motor control, but each skill develops independently (Hop­

per and Naremore, 1973).

Motor Development

The second through the seventh years is considered the

most critical period for normal motor development (Mcclenaghan

and Gallahue, 1978). By the end of the second year the child

has mastered the "rudimentary movement abilities" that are

developed during infancy. These movements form the basis on

which the child develops "fundamental movement patterns" of

early childhood. At three years, according to Wood (1964), a

child has temporarily mastered gross and fine motor skills,

but at four years of age much of the coordination mastered in

the past becomes disrupted and he may appear poorly coordin­

ated. By the age of five or six years, Mcclenaghan and Gall­

ahue have observed that the child's movements are " •••

mechanically efficient, coordinated, and controlled perform­

ances." For normal motoric development, the child must have

quality and a variety of movement experiences.

Related Studies

It would appear the theories postulated by Kephart

8

(1960}, Barsch {1966}, Lenneberg (1967}, and Delacato {1973},

have served as basic foundations by which further studies

have been conducted. Researchers have taken an interest in

correlating motor skills with articulation disorders {Jenkins

and Lohr, 1964; Powers, 1971; and Sommers and Kane, 1974};

oral and verbal diadokokinetic rates {Fletcher, 1972}; learn­

ing disabilities {Turton, 1975; and Bruininks, 1978}; and

mental retardation {Ismail, Kephart, and Cowell, 1963; and

Myklebust, 1971}. The present study is more concerned with

language. Researchers have found limited studies correlating

motor skills with language or language delays.

Researchers have sought to find an interrelationship

between language and motor skills other than known develop­

mental patterns cited in the literature {Sprague, 1961}.

Sprague conducted a study using 62 eight year old boys with

normal language. The purpose of the study was to determine

how expressive language skills were related to motor skills.

Expressive language skills were measured by Mean Length of

Response {MLR} , Mean of the Five Longest Response {MSL} , Num­

ber of One Word Responses {NIW} , Structural Complexity of Re­

sponse {SCS), and Number of Different Words Used in Response

9

(NDW). The measures of motor skills included Running, Stick

Balance, Throwing, Jumping, and Manual Dexterity (Placing and

Turning). There were correlations beyond the .OS level of

probability with the manual dexterity items. According to

the data, NIW was the only expressive language measurement

which showed a significant negative correlation, (r. = -.28)

with Placing. This means the subjects' performance scores

were low on the Placing task and high on the NIW expressive

language measurement. MSL (r. = +.18), SCS (r. = +.06), MLR

(r. = +.18), and NDW (r. = +.18), did not reach statistical

significance with the Placing task. Turning showed signifi­

cant positive correlations with MSL (r. = +.28), and NDW

(r. = +.29), while NIW showed a negative correlation

(r. = -.30) with Turning. MLR (r. = +.21 and SCS (r. = +.10)

were not highly correlated with Turning. In regard to the

gross motor items, Sprague did not find correlations with MLR,

MSL, scs, NDW, or NIW. Therefore, Sprague concluded there

were correlations between measures of expressive language and

manual dexterity but not between gross motor skills and ex­

pressive langauge.

According to Luria (1961) , after four and one-half years

of age a child begins to use his internalized verbal system

to organize sequences of motor activity. In addition, the

differences in the quality and quantity of verbal output

should correspond to analogous attributes of motor behavior.

The investigator observed and analyzed "retarded speech" and

motor actions of identical twins. The pair was observed

10

while interacting with other children of the same age during

play activities. Observation of the twins indicated they did

not participate in mobile action games, such as, chasing and

catching. The twins' drawings, paintings, and building with

blocks were below the age level of other playmates the same

chronological age. Luria concluded the twins were unable to

engage in productive, complex motor activity due to limited

internal operations. In a follow-up experiment, language

management was given to one of the twins. The other twin did

not have language management. Each session focused on in­

creasing sentence development. Three months later, the twins

were observed. Results indicated speech improvement as well

as meaningful, constructive, motor activity in the one twin

who participated in language management. Not only did the

child develop new forms of verbal communication, but signifi­

cant changes were evident in the structure of conscious activ­

ity, built on the basis of verbal speech. The other twin,

without langauge management, appeared to have no changes in

motor skills or verbal communication. As a result of the

study, the investigator noted a possible interrelationship

between a child's motor actions and his quality of expressive

communication.

Wolff and Wolff (1972) examined the correspondence be­

tween quantity and sophistication of verbal output and the

child's production of gross and fine motor movements. In the

study, the investigators used three groups of normal language

developing children four through five years of age with each

11

group consisting of 23, 17, and 15 children respectively.

The children were assessed by their teachers on the basis of

perceived verbal output ("talkativeness"), verbal skills

("the level of sophistication"}, gross and fine motor activ­

ity, and manual dexterity. The investigators found high cor­

relations between the quantity of verbal output and the quan­

tity of gross motor activity (r. = +.596); whereas, verbal

skills were not significantly related to gross motor activity

(r. = +.007). Ratings on fine motor and manual dexterity

tasks, however, were significantly related to verbal skills

(r. = +.668 and +.556, respectively). Fine motor and manual

dexterity were more highly related to verbal skills than to

verbal output (p> .025 in each dimension). Verbal output is

more highly related to gross motor than to fine motor (p>.14),

or to manual dexterity (p>.026). Conversely, verbal skills

are more highly correlated with both fine motor and manual

dexterity than with gross motor (both p's >.001). The corre­

lation of verbal skills with verbal output is lower than

either fine motor (p> .024) or manual dexterity (p >.073).

In general, the results of the Wolff and Wolff study indicated

that while incidence of gross motor activity is associated

primarily with quantity of speech output, degree and inciden:e

of fine manipulative activity is more related to degree of

verbal sophistication. Wolff and Wolff stated that, ".

these correlations are consistent with the clinical observa­

tions of Luria and Yudovich (1959) that quality of verbal out­

put mirrors quality of motor activity. Needless to say, no

12

casual relationships are implied by the present results."

Summary

Within the field of Speech-Language Pathology, research­

ers have hypothesized an interrelationship between motor

skills and articulation disorders, oral diadokokinetic rates,

learning disabilities, and mental retardation. Relatively

few studies have correlated motor skills and expressive lan­

guage delay in children. Since Speech-Langauge Pathologists

have had an increased concern in language, normal and disor­

dered, it is important to determine if a correlation exists

between expressive langauge delay and motor abilities. It

also is important to isolate specific motor variables most

affected within the population.

CHAPTER III

METHODS AND PROCEDURES

Methods

Subjects

Twenty children, ranging in age from five years through

six years, eleven months with a diagnosis of an expressive

language delay of twelvemonths or more, were chosen to parti­

cipate in this investigation. The mean age of the group was

five years, eight months. Their diagnosis was based on the

Individual Educational Program completed by an Oregon certi­

fied Speech-Language Pathologist. The children were selec­

ted from the public schools in the greater Portland area.

Screening

Children who met the above stated criteria and returned

the parent permission forms (see Appendix A) participated in

screening procedures, which included: a pure-tone, audiome­

tric screening test at 25 dBHL for the frequencies of 500,

1000, 2000, and 4000 Hz; and, Form L of the Peabody Picture

Vocabulary Test-(PPVT) Revised (Dunn, 1981). Each candidate

had normal hearing acuity in the better ear and a receptive

language age within two standard deviations of their chrono­

logical age. In addition, the subjects had no broken bones,

14

sprained limbs, or any other motor dysfunctions.

Instruments

The Preschool Language Scale. The expressive portion

of the Preschool Language Scale-PLS (Zimmerman, Steiner, and

Evatt, 1969) was utilized to measure expressive language

skills. The PLS was designed as an evaluation instrument for

isolating strengths and weaknesses in receptive and expres­

sive language skills for children one year, six months, to

seven years of age. The PLS has individual subtests asses­

sing "Auditory Comprehension Ability" (AC) and "Verbal Abil­

ity" (VA). For the purposes of this study, the VA was util­

ized. A total of eighty items are included throughout the

VA and AC subtests, with forty items in each subtest. The

concepts measured are: logical thinking; sensory discrimin­

ation; grammar; vocabulary; memory; attention span; and tem­

poral and spatial relations. The VA scale measures articula­

tion as well.

Each item has a specified passing criteria described in

the test manual and test form. Initially, the child is tested

at an age level below his estimated ability. Basal age is

established when four test items at a given age level are

correct. Testing continues until all test items at an age

level are missed. From the basal age score, language age

equivalents for both AC and VA may be determined. In addi­

tion, AC and VA quotients and an overall Language Age are es­

tablished. For the purposes of this study only a VA age

15

equivalent was determined for each child.

The PLS has a reliability rating of .88, using a split­

half reliability coefficient. Concurrent validity was estab­

lished by correlating the PLS with scores on the Illinois

Test of Psycholinguistic Ability-(ITPA), Utah Test of Language

Development-(UTLD), and the Peabody Picture Vocabulary Test-

(PPVT). Higbee (1974) administered the ITPA and the PLS to a

sample of cerebral palsied children aged 4 to 10 years old,

with a Pearson correlation coefficient ranging from .94 to

.99. Scott (1973) assessed thirty-two middle-class children,

aged three to four years, using the UTLD and the PLS. The

Pearson correlation coefficient was .70. Zimmerman and

Steiner (1971) assessed twenty-five Head Start children using

the PPVT and the PLS with a Pearson correlation coefficient

ranging from .66 to .68.

The Bruininks-Oseretsky Test of Motor Proficiency. The

short form of the Bruininks-Oseretsky Test of Motor Prof ici­

ency- (BOMP) (Bruininks, 1978) was used to measure each sub­

ject's motor skills. The test was designed to assess both

gross and fine motor skills in children four years, six

months, to fourteen years, six months. Bruininks based part

of the test on the United States adaptation of the Oseretsky

Test of Motor Proficiency (Doll, 1946). The items in the or­

iginal Oseretsky test were evaluated according to criteria

established to guide both selection of old items and the de­

velopment of new items. Bruininks divided the test into

16

eight subtests, including: four gross motor sections (run­

ning speed and agility, balance, bilateral coordination, and

strength) ; three fine motor sections (response speed, visual

motor control, and upper-limb speed and dexterity); and one

subtest assessing both gross and fine motor skills (upper­

limb coordination) •

The complete form of the test consists of forty-six

test items, fourteen of which make up the short form. Since

many items on the test require using arm or leg preference,

Bruininks includes a pretest. This portion of the BOMP is

not considered in the final scoring and anlysis. All of the

items on the short form are administered to each child as

presented in the manual. At the end of testing, scores are

totaled and converted into percentile ranks, standard scores,

and stanine scores.

The reliability rating for the BOMP was determined by

test-retest from 63 second graders and 63 sixth graders.

Test-retest reliability for the gross motor composite was .77,

.88 for the fine motor composite, .89 for the battery compos­

ite, and .87 for the short form.

Procedures

Each child meeting subject and screening criteria was

given the PLS and the BOMP in a quiet classroom. Prior to

test administration, furniture was rearranged to clear a

large area for the motor task performances on the BOMP. Ini­

tially, rapport was established with each child by engaging

17

in a two minute conversation with the investigator. The ex­

pressive portion of the PLS was given with the child seated

at a table across from the examiner. The test was adminis­

tered according to the instructions and criteria stated in

the manual. When basal and ceiling ages were established,

each child received a three minute rest period.

Prior to administering the short form of the BOMP, each

child performed two tasks presented in the pretest following

the tester's demonstration. All instructions on the pretest

and the short form were read as stated in the manual. As

the items were performed by the children, they were scored

according to the criteria described. Positive reinforcement,

such as "good listening" and "nice sitting," was given

throughout the testing situation. Together, the PLS and the

BOMP took approximately forty-five minutes to administer to

each child.

Reliability of Data

Inter-judge reliability on the expressive portion of

the PLS was established between this investigator and a pre­

vious graduate student from the Speech and Hearing Sciences

Program at Portland State University. To establish inter­

judge reliability, five children ranging in age from five

years through six years, eleven months, were randomly chosen

from the Helen Gordon Child Care Center. Initially, the in­

vestigator set-up a training session with the judge to review

the test, including the administration, scoring, and

18

evaluation procedures. Following the training session, each

child was administered the PLS by the investigator. The re­

sponses were scored and analyzed by the investigator and the

judge, with an inter-judge reliability score of 1.00.

Intra-judge reliability was established by the inves­

tigator one week following the inter-judge reliability test­

ing. Each child was individually tested according to the

procedures stated in the manual. After the responses were

scored and analyzed, the investigator compared the scores

with the inter-judge reliability test scores. Intra-judge

reliability was determined to be .80. The intra-judge score

for the independent judge was .90.

Inter-judge reliability on the short form of the BOMP

was established between this investigator and an instructor

at Portland State University who was proficient in adminis­

tering the test. The instructor and investigator, for cali­

bration purposes, reveiwed the administration, scoring, and

analysis of the BOMP. Following the training session, the

short form of the BOMP was administered to two children with

the same age range used to establish reliability for the PLS.

The BOMP was administered, scored, and analyzed by the inves­

tigator and the independent judge with a reliability coeffi­

cient of .90.

Intra-judge reliability for the BOMP was established by

the investigator one week following the inter-judge reliabil­

ity testing. The test was administered, scored, and analyzed

according to the test manual. The investigator compared these

scores with the scores from the inter-judge reliability ra­

ting. Intra-judge reliability was determined to be 1.00.

The intra-judge score for the independent judge was 1.00.

Analysis of Data

19

The Pearson Product-Moment Correlation coefficient (r.)

was used to determine the association between the subjects'

Verbal Ability Age on the PLS and the motor performance

scores on the BOMP. Means and standard deviations were com­

puted for each variable on the BOMP as well. One-tailed t­

tests were implemented to assess the significance of the

Pearson Product-Moment Correlation with eighteen degrees of

freedom, and a probability level of .OS.

CHAPTER IV

RESULTS AND DISCUSSION

Results

The purpose of the present investigation was to deter­

mine the association between expressive language delay in

children and their motor abilities. Specifically, the study

assessed expressive language using the "Verbal Ability" por­

tion of the Preschool Language Scale-PLS (Zimmerman, et al.,

1969) , and the short form of the Bruininks-Oseretsky Test of

Motor Proficiency-BOMP (Bruininks, 1978). Twenty children

were selected to participate in the study, ranging in age

from five years through six years, eleven months. The mean

chronological age of the population was 67 months with a

standard deviation of 4.47 months (see Table I). The expres­

sive language age delay ranged from 12-30 months, with a mean

of 18.5 months and a standard deviation of 4.69 months.

The first question posed was: Is there a significant

relationship between an increased expressive language delay

and reduced motor abilities in children with a language delay?

A Pearson Product-Moment Correlation Coefficient was used to

determine the extent of association between the subjects' ex­

pressive language age delay on the PLS and the "Motor Scores"

on the BOMP. In addition, a one-tailed t-test was computed

*

TABLE I

MEAN AND STA.J.~DARD DEVIATION OF THE SAMPLE'S CHRONOLOGICAL AGE IN COMPARISON TO THE

EXPRESSIVE LANGUAGE AGE DELAY, MEAN AND STANDARD DEVIATION

AS MEASURED BY THE PLS

Chronological Age Preschool Language Scale

SD Range of Delay SD

67* 4.47 12-30* 18.5 4.69

figures represent months

21

for each correlation coefficient to determine the statistical

significance of the r. values in the predicted (negative) di-

rection. The Standard Score was 44.50 with a standard devia-

tion of 8.92 (Table II). The Total Point Score produced a

mean of 24.25, and a standard deviation of 7.94. The mean of

the Percentile Rank was 34.40 with a standard deviation of

25.64. Table II also reports the correlation between the

subjects' language age delay and "Motor Scores." All three

correlations were in the expected direction; however, only

the Standard Score generated correlation was of at least mod-

erate strength (see Appendix C), r. = -.41, p.> .05. The

Total Point Score generated a slight inverse correlation,

r. = -.17, while the Percentile Rank posted a low correlation,

r. = -.27. In answer to the first question, then, there is a

slight to moderate inverse correlation between expressive

language delay in children and their motor abilities.

TABLE II

MEAN, STANDARD DEVIATION, ANALYSIS OF CORRELATION BETWEEN THE PLS AND THE BOMP, AND t-TEST

RESULTS

Bruininks-Oseretsky Test of Motor Proficiency

Total Point Score

Standard Score

Percentile Rank

24.25

44.50

34.40

a = one-tailed t-test DF=l8

* p = >. 05

SD

7.94

8.92

25.64

r.

-0.17

-0.41

-0.27

t-testa

.732

1.906*

1.189

22

The second question posed was: What specific gross and

fine motor skills had the strongest association with expres-

sive language delay? Table III shows the point sc9re ranges, /

means, standard deviations, correlations, and t-test results

on the items from the short form of the BOMP. It can be seen

there are negligible correlations in many of the gross motor

items. Three out of six fine motor test items, however, had

slight to moderate negative correlation coefficients. Item

11, "Copying a Circle," had a moderately-strong inverse cor-

relation with language age delay {r. = -.48), but item 9

posted a low correlation (r. = -.24), and item 12 generated a

slight correlation (r. = -.37). This means the children with

low expressive language abilities demonstrated lower perform-

ance on "Copy.ing a Circle" than "Response Speed," or "Copying

Overlapping Pencils." "Copying a Circle" was the only test

TA

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24

item generating a moderate correlation with expressive lan­

guage delay, and hence, a significant association beyond the

.OS alpha level. "Copying Overlapping Pencils" registered

just below the .05 alpha level.

Further inspection of Table III shows two items with

positive correlations, contrary to expectations. Item 2,

"Walking Heel-to-Toe on a Balance Beam," and item 6, "Catch­

ing a Tossed Ball," had slight to low positive correlations,

r. = +13 and +.30, respectively. This means the children

with high language age delay tended to demonstrate an increase

in performance scores on "Walking Heel-to-Toe on a Balance

Beam," and "Catching a Tossed Ball."

In answer to question two, then, "Copying a Circle,"

"Copying Overlapping Pencils," and "Response Speed" register­

ed the strongest correlations with expressive language age

delay in the expected direction (inverse) , with "Copying a

Circle," showing the strongest correlation, r. = -.48, with

expressive language delay.

In summary, the data of the present study indicate that

expressive language delayed children demonstrated slight to

moderate fine motor coordination deficits. On-the-other-hand,

expressive language delayed children definitely do not appear

to have marked deficits in gross motor coordination, especial­

ly with "Catching A Ball" and Walking Heel-to-Toe."

DISCUSSION

According to test results for the first question posed,

25

expressive language delay in children tends to be associated

with reduced motor skills, as measured by the Standard Score

of the BOMP. Except for Luria (1961), other studies have

not measured motor skills in terms of overall abilities, but

instead assess individual motor skill items which correlate

with language abilities. In this study, not only were indi­

vidual items correlated, but an overall measurement, the

Standard Score, was used as a means to correlate a child's mo­

tor skills, which encompass both gross and fine motor abili­

ties in the several subtest items.

The results of the Standard Score (refer to Table II)

support the concluding observations made by Luria (1961) . He

suggested a possible interrelationship between a child's mo­

tor skills and his quality of communication. The size, age,

and experimental design differed from the present study.

Luria's study used two identical twins, 4.5 years of age with

"retarded speech." The present investigation, however, in­

cluded twenty children, 5.0 through 6.11 years of age, with

expressive language delay.

Luria (1961) assessed the twins' motor skills based on

observational procedures. They were placed in a setting with

other age-mates and were given toys including paper, pencils,

paints, and building blocks. In contrast, the experimental

design of the current study included two standardized tests,

the BOMP and the PLS. Even though there were methodology

differences between Luria's study and the present study, the

concluding observations by Luria were appropriate for

26

comparison in the present study.

The results of the second question posed in the current

investigation indicated a tendency for language delayed chil­

dren to have reduced, fine motor skills. The results of the

present study are compatible with earlier studies. Sprague

(1961) found correlations beyond the .OS alpha level between

manual dexterity tasks, "Placing" and "Turning," and expres­

sive language. According to the data, NIW (Number of One

Word Responses) indicated a weak inverse correlation (r. =

-.28) with the "Placing" task, while MLR (Mean Length of Re­

sponse) , MSL (Mean of the Five Longest Responses) , SCS (Struc­

tural Complexity of Response), and NOW (Number of Different

Words used in Response), registered negligible correlations,

r. = +.08, +.18, +.06, +.18, respectively. "Turning," also

classified as a manual dexterity item, showed significant

correlations with MSL (r. = +.28), NIW (r. = -.30), and NDW

(r. = +.29). Significant correlations were not obtained with

MLR (r. = +.21) and SCS (r. = +.10). Negligible correlations

were found between each of the expressive language measures

and all of the gross motor task items, which included: Run­

ning, Stick Balance, Jumping, and Throwing. In Sprague's

study (1961), correlations were found between "Placing" and

"Turning," manual dexterity tasks, and expressive language.

Negligible correlations were evident between measures of

gross motor skills and measures of expressive language. The

data presented in this study appear to support Sprague's

findings correlating expressive language and fine motor skills.

27

The results of the current study tend to be compatible

with the Wolff and Wolff study (1972} as well. Although due

to methodology differences a one-to-one relationship with the

present study is not possible. Wolff and Wolff used teacher

rating scales to collect data, while the current study used

standardized tests for data collection purposes. This inves­

tigator found a negligible correlation (see Table III) be­

tween gross motor skills and expressive language delay. Ac­

cording to Wolff and Wolff, verbal skills (sophistication of

language) were not significantly correlated with gross motor

skills (r. = .007). Fine motor and manual dexterity tasks,

however, were significantly correlated with verbal skills,

r. = .668, and .556, respectively. In the present study

there was a significant correlation between expressive lan­

guage delay and fine motor skills. Three out of six fine

motor itmes had moderate to weak inverse correlations (see

Table III}. "Copying a Circle," which Bruininks (1978) clas­

sifies as a manual dexterity task, registered the only moder­

ate inverse correlation, r. = -.48. "Copying Overlapping

Pencils," also a manual dexterity task, r. = .37 registered

a low inverse correlation.

A possible explanation for the correlations obtained in

the present investigation might be due to maturation. Accord­

ing to Williams (1982), the ability to copy forms from visual

models is "nearly mature" at the age of nine, with most growth

occurring between ages five through seven. It would appear,

then, that the children in the present investigation had not

28

fully developed the ability to copy forms appropriately from

a visual model. Therefore, the children would not achieve a

maximum point score. In other words, their motor skills were

impeded, or beyond the appropriate age level.

The children's motivation also might be a possible ex­

planation for the lower performance scores on items 11 and 12,

manual dexterity tasks. From observation, it appeared to

this investigator that the subjects were more willing and rno­

ti vated to perform gross motor tasks than fine motor tasks.

Although this might also have been true with the standardiza­

tion group of the BOMP. The performance scores in the pre­

sent study might have reflected the children's motivational

level throughout the assessment.

In the gross motor subtest, items 2, "Walking Heel-to­

Toe on a Balance Beam," and i tern 7, "Catching a Tossed Ball,"

had weak positive correlations, r. = +.17, and +.30, respec­

tively. This is contrary to the expected outcome. Cultural

factors might account for these correlations. The society in

the United States appears to encourage children to learn how

to catch balls, perform balancing acts, etcetera, which can

be observed not only in parent-child interaction and play ac­

tivity with siblings but with age-mates, during physical edu­

cation classes and at school.

It also should be noted that six test items on the short

form of the BOMP had truncated point score ranges (Table III).

Due to the narrow point score ranges of these items, there is

an underestimated magnitude of the correlations. If the point

29

score ranges were increased, it is predicted that the correl­

ations between the expressive language age delay and the mo­

tor skills might increase.

In general, most of the activities in the gross motor

subtest of the BOMP primarily involve the child's entire body

in space. The fine motor subtests, however, require precise

movements. Along these lines, expressive language partly in­

volves fine motor control of the speech musculature. The

quality of language, then is partially dependent on the child's

ability to move the speech musculature, which requires simi­

lar precise movements. Therefore, one would not expect to

see correlations between gross motor skills, and expressive

language delay, but correlations between fine motor skills

and expressive language delay would appear to be plausible.

In summary, there was a negligible inverse correlation

between expressive language delay and gross motor skills. In

relation to the fine motor skills, on the other hand, three

out of six items had a low or moderate inverse correlation.

There appears to be an indication for language delayed chil­

dren to have greater difficulty with fine motor tasks than

gross motor tasks. In the present study, the population's

performance on manual dexterity items, in the fine motor sub­

test, appeared to be lower, and more difficult than the items

on the gross motor subtest.

CHAPTER V

SUMMARY AND IMPLICATIONS

Summary

Lenneberg (1967) noted that as a child matures a gener­

al growth pattern is observed with both language skills and

motor skills co-developing. Most of the research relating to

motor skills deals with articulation skills, oral diadokokin­

etic rates, learning disabilities, and intelligence. Rela­

tively few studies, however, appear to correlate motor skills

with expressive language delay in children.

The purpose of the present study was to determine the

correlation between expressive language delay in children and

their gross and fine motor skills. Twenty children, five

years through six years, eleven months with a diagnosed ex­

pressive language delay, were selected to participate in the

study. Each was screened on the basis of normal hearing, re­

ceptive vocabulary skills, motor functioning, and an expres­

sive language delay of one year or more. After screening pro­

cedures, each child was administered the Preschool Language

Scale-PLS (Zimmerman, et al., 1969) and the short form of the

Bruininks-Oseretsky Test of Motor Proficiency-BOMP (Bruininks,

1978) • The data were analyzed using a Pearson Product-Moment

Correlation along with means, standard deviations, and a

31

one-tailed ~-test of significance.

According to the data results, the Standard Score, an

overall measurement of the children's motor skills, indicated

a moderate inverse correlation, r. = -.41, while the Total

Point Score, r. = -.17, and the Percentile Rank, r. = -.28,

had weak inverse correlations. In relation to the individual

test items, negligible correlations were indicated in the

gross motor items, "Walking Heel-to-Toe," and "Catching a

Tossed Ball," classified as gross motor tasks, obtained posi­

tive correlation, r. = +.13, and +.30, respectively.

There were three out of six fine motor tasks with low

to moderate inverse correlations: "Copying a Circle" gener­

ated a moderately-strong inverse correlation, r. = -.48;

"Copying Overlapping Pencils," and Response Speed," posted

low inverse correlations, r. = -.37 and r. = -.24, respective­

ly. A one-tailed ~-test revealed subjects performed these

three items more poorly than the gross motor and some fine

motor tasks on the BOMP. The expressive language delayed

children tended to have deficits in manual dexterity tasks

but not in gross motor tasks.

The results obtained from the present study were com­

patible with the research conducted by Sprague (1961) and

Wolff and Wolff (1972). Both investigators found significant

correlations between fine motor tasks and expressive language.

Negligible correlations were indicated between gross motor

skills and expressive language. It was concluded by the pre­

sent investigator that children with expressive language delay

32

might have deficient fine motor development.

Implications

Research

Further investigations correlating expressive language

delay with motor abilities is warranted. In this study, the

short form of the BOMP was used as a means of assessing the

children's motor skills. For more valid results, the complete

battery of the BOMP should possibly be used. The long form

includes eight subtests with forty-six test items. The short

form includes eight subtests and fourteen test items. In ad­

dition, the long form has normative data, age equivalents,

standard scores, and percentile ranks. By using the complete

battery, perhaps the investigator could determine additional

skills which correlate with the subjects' language age delay.

The investigation included a limited number of subjects

(20) with a narrow age range. It may be of interest in fur­

ther studies to have a larger number of language delayed sub­

jects with cells of different age groups, encompassing the

age range five years through fourteen years. The performance

of the older children in fine motor tasks might yield differ­

ent results than the younger children. The results of the

study should determine whether or not the older children have

low performance in the same skill areas as the younger chil­

dren. Furthermore, determine which motor skill areas each of

the age groups appear to have difficulty in performing.

33

Clinical

There is an increasing need for Speech-Language Pathol­

ogists to not only focus on a child's speech and language,

but to have an overall awareness of his total development.

This is especially important in the public school setting.

The results of the present study may be of further assistance

to the Speech-Language Pathologist in diagnosing a child with

an expressive language delay. Their input on the child's mo­

tor skills in relation to language skills would be valuable

information, especially within a multidisciplinary team.

From the evidence discussed in the current investiga­

tion, it is apparent that children with expressive language

delay tend to have fine motor deficits, but not gross motor

deficits. Intervention techniques using gross motor tasks

with language delayed children need to be reviewed with more

emphasis placed on fine motor tasks, such as drawing, tracing

around shapes, copying shapes from a visual model, etcetera.

By using these techniques, both a child's language skills

and fine motor skills might be stimulated together.

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APPENDIX A

PARENT PERMISSION FORM

Dear Parent or Guardian,

My name is Gail Cunningham. I am a second year gradu­ate student at Portland State University in Speech-Language Pathology, and currently involved with a research project. The purpose of my study is to determine the relationship that exists between a child's language delay and his motor abili­ties (i.e., running, jumping, pencil tracing, response speed, etc.). The term "language delay," in this study, refers to language which follows a normal pattern of development, but is below age level according to the child's age. Twenty chil­dren, kindergarten through first grade, will be needed to run the study. ·

In my study, I will use a language test, the Preschool Language Scale, which looks at a child's spoken language, and the Bruininks-Oseretsky Test of Motor Proficiency, which looks at a child's gross motor (running, jumping, catching a ball) and fine motor skills (tracing, response speed, making pencil dots) . The children will be tested individually in two 30 minute sessions. I would like your permission to include your child in this study. The name of your child and the test scores will be kept in strictest confidence. The name of your child will not be used in the written portion of the study. If your child does not wish to participate, he/she may leave voluntarily.

Please complete the letter below indicating your approval, and return with your child to school tomorrow.

. . . . . . . . . . . . . . . . . I, , agree to let my child, ~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~' participate in Gail Cunning-

ham's study. Date

Thank you for your cooperation.

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APPENDIX C

VALUE GUIDELINE OF PEARSON PRODUCT-MOMENT CORRELATION COEFFICIENT

~ .20 slight; almost negligible correlation

.20-.40 low correlation; definite but small relationship

.40-.70 moderate correlation; substantial relationship

.70-.90 high correlation; marked relationship

(Guilford, 1956)